Intrarater and interrater reliability and validity in the assessment of the mechanism of injury and integrity of the posterior ligamentous complex: a novel injury severity scoring system for thoracolumbar injuries. Invited submission from the Joint Section Meeting On Disorders of the Spine and Peripheral Nerves, March 2005.
Publication/Presentation Date
2-1-2006
Abstract
OBJECT: A new classification and treatment algorithm for thoracolumbar injuries was recently introduced by Vaccaro and colleagues in 2005. A thoracolumbar injury severity scale (TLISS) was proposed for grading and guiding treatment for these injuries. The scale is based on the following: 1) the mechanism of injury; 2) the integrity of the posterior ligamentous complex (PLC); and 3) the patient's neurological status. The reliability and validity of assessing injury mechanism and the integrity of the PLC was assessed.
METHODS: Forty-eight spine surgeons, consisting of neurosurgeons and orthopedic surgeons, reviewed 56 clinical thoracolumbar injury case histories. Each was classified and scored to determine treatment recommendations according to a novel classification system. After 3 months the case histories were reordered and the physicians repeated the exercise. Validity of this classification was good among reviewers; the vast majority (> 90%) agreed with the system's treatment recommendations. Surgeons were unclear as to a cogent description of PLC disruption and fracture mechanism.
CONCLUSIONS: The TLISS demonstrated acceptable reliability in terms of intra- and interobserver agreement on the algorithm's treatment recommendations. Replacing injury mechanism with a description of injury morphology and better definition of PLC injury will improve inter- and intraobserver reliability of this injury classification system.
Volume
4
Issue
2
First Page
118
Last Page
122
ISSN
1547-5654
Published In/Presented At
Harrop, J. S., Vaccaro, A. R., Hurlbert, R. J., Wilsey, J. T., Baron, E. M., Shaffrey, C. I., Fisher, C. G., Dvorak, M. F., Oner, F. C., Wood, K. B., Anand, N., Anderson, D. G., Lim, M. R., Lee, J. Y., Bono, C. M., Arnold, P. M., Rampersaud, Y. R., Fehlings, M. G., & Spine Trauma Study Group (2006). Intrarater and interrater reliability and validity in the assessment of the mechanism of injury and integrity of the posterior ligamentous complex: a novel injury severity scoring system for thoracolumbar injuries. Invited submission from the Joint Section Meeting On Disorders of the Spine and Peripheral Nerves, March 2005. Journal of neurosurgery. Spine, 4(2), 118–122. https://doi.org/10.3171/spi.2006.4.2.118
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
16506478
Department(s)
Administration and Leadership
Document Type
Article